王浩,杨静容,欧静琳.甲泼尼龙联合阿奇霉素治疗RMPP患儿的临床效果.[J].中南医学科学杂志.,2016,(4):442-446.
甲泼尼龙联合阿奇霉素治疗RMPP患儿的临床效果
Clinical Effect of Methylprednisolone Combined with Azithromycim in the Treatment of Children with RMPP
投稿时间:2016-01-09  修订日期:2016-06-26
DOI:
中文关键词:  激素  阿奇霉素  RMPP  免疫系统
英文关键词:hormone  azithromycin  RMPP  immune system
基金项目:
作者单位
王浩 成都市新都区人民医院药剂科,四川 成都 610036 
杨静容 成都市新都区人民医院儿科 
欧静琳 陕西省安康市中医医院儿科 
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中文摘要:
      目的 观察甲泼尼龙联合阿奇霉素对儿童难治性支原体肺炎(PMPP)的治疗效果。方法以2013年3月~2015年6月在我院接受治疗的80例PMPP患儿为观察对象,并将其随机分为对照组和观察组,每组各40例患者。其中,对照组给予阿奈素治疗,观察组在此基础上给予甲泼尼松龙治疗。观察两组患儿的治疗效果和不良反应发生率;比较两组患儿治疗前后炎症细胞因子水平及免疫指标的差异。结果观察组治疗的总有效率明显高于对照组,差别具有统计学意义(P<0.05);观察组患儿热程、住院天数、阿奇霉素使用时间以及病情反复次数均较对照组少(P<0.05);两组患儿治疗前的IL-6、IL-8、IL-10、TNF-α、IFN-γ和CRP等炎症细胞因子水平无明显差别,治疗后,两组患儿的上述指标均降低,且观察组降低更为明显(P<0.05);两组患儿治疗前IgG、IgM、CD3+、CD3+/CD4+、CD3+/CD8+和CD4+/CD8+等血清免疫学活性指标无明显差别,治疗后两组患儿的IgG、IgM和CD3+/CD8+均下降,CD3+、CD3+/CD4+和CD4+/CD8+均升高,且观察组上述指标的变化更为明显(P<0.05);两组患儿治疗期间胃肠道反应、皮疹、头痛等不良反应发生率无明显差别(P>0.05)。结论甲泼尼龙联合阿奇霉素对儿童难治性支原体肺炎有较好的治疗效果,可能与其能降低机体炎症细胞因子水平,调节机体免疫系统有关,且对患儿副作用小,值得在临床推广应用。
英文摘要:
      Objective To observe the effect of methylprednisolone combined with antibiotics in the treatment of children suffered from refractory mycoplasma pneumonia(RMPP).Methods80 cases of patients with PMPP treated in our hospital from March 2013 to June 2015 in our hospital were selected and randomly divided into control group and observation group,40 cases in each group.The control group was treated with azithromycin,the observation group was treated with methylprednisolone and azithromycin.The therapeutic effect and adverse reactions were obseved,and the inflammatory cytokines and immune index between the two groups before and after treatment were tested.ResultsThe total effective rate of the observation group was significantly higher than that of the control group(P<0.05); the treatment effecacy between the two groups,thermal process,length of stay,the use of antibiotics,and the number of patients with recurrent disease of observation group were less than the control group (P<0.05).The level of inflammatory cytokines such as IL-6,IL-8,IL-10,TNF-α,IFN-γ,and CRP had no significantly difference between the two groups before treatment,but the above indexes of the two groups all decreased after treatment,while the observation group was significantly lower (P<0.05).The serum immunological activity as IgG,IgM,CD3+,CD3+/CD4+,CD3+/CD8+,CD4+/CD8+,and CD3+/CD8+ of the two groups had no significant difference before treatment.After treatment,the level of IgG,IgM and CD3+/CD8+ were decreased,and CD3+,CD3+/CD4+,and CD4+/CD8+ all increased,the change of the observation group was more obvious (P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups in the treatment as gastrointestinal tract reaction,skin rash,headache,and so on(P>0.05).ConclusionsMethylprednisolone combined with antibiotics in the treatment of children with refractory Mycoplasma pneumonia has better therapeutic effect,which may due to it reduce the level of inflammatory cytokines and regulate the immune system.and it has little side effect,which is worth popularizing in clinical application.
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